Disease Information for Transfusion Related Acute Lung Injury/TRALI syndrome

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Clinical Manifestations
Signs & Symptoms
Acute Chest Pain
Chest Pain
Cyanosis
Low Blood Pressure
Signs of Poor Perfusion
Cough
Dyspnea
Dyspnea at rest
Rales
Rales,fine dry diffuse
Rapid Breathing
Respiratory distress
Shortness of breath/SOB
Tachypnea/Increased respiratory rate
Fever
Flu-Like Syndrome
High body temperature
Clinical Presentation & Variations
Presentation/Transfusion Dyspnea Shock Hhypoxia
Disease Progression
Course/Catastrophic presentation/onset
Course/Fulminant/Precipitous
Course/Lethal possible/not usual
Prognosis/Recovery/reversable usually
Demographics & Risk Factors
Exposure Factors
Exposure/Specific blood donor
Established Disease Population
Patient/Chemotherapy/cancer
Patient/Blood transfusion/recent
Population Group
Population/Hospital patient
Occupational Factors
Setting/Hospital setting
Setting/Intensive/postop/cardiac care unit
Laboratory Tests
Abnormal Lab Findings (Non Measured)
Acute inflammatory markers elevated (Lab)
Abnormal Lab Findings - Decreased
Arterial Hgb O2 saturation (Lab)
Platelet count (Lab)
Abnormal Lab Findings - Increased
Isohemagglutinin titers (Lab)
Lactic Dehydrogenase (LDH LH) (Lab)
Neutrophile/Leukoagglutinins Antibody Test
Diagnostic Test Results
X-RAY
Xray/Chest abnormal
Xray/Bilateral pulmonary infiltrates/Chest
Xray/Chest/Lung fields/Abnormal
Xray/Generalized alveolar disease/Chest
Xray/Infiltrate, pulmonary/Chest
Xray/Interstitial infiltrate, acute/Chest
Xray/Pneumonitis/pattern no infection/Chest
Xray/Whiteout/lung fields/Chest
Associated Diseases & Rule outs
Rule Outs
Amniotic fluid embolism
Cardiogenic Pulmonary Edema
Disseminated intravascular coagulation
Pneumonia
Pneumonia, bacterial
Pneumonia, interstitial, acute
Pneumonia, viral
Pneumonia/Bronchopneumonia
Pulmonary edema
Pulmonary edema/acute left vent failure
Pulmonary embolism
Transfusion/anaphylaxis foreign protein reaction
Associated Disease & Complications
Blood transfusion/misadventure
Hypotension
Hypoxia, systemic
Pulmonary edema/non-cardiogenic
Respiratory distress (adult) syndrome
Respiratory failure/Pulmonary insufficiency
Shock
Transfusion reaction
Transfusion Related Acute Lung Injury
Disease Mechanism & Classification
Class
CLASS/Immune System Disorder (ex)
CLASS/Alveolar disorder
CLASS/Pulmonic (category)
Pathophysiology
Pathophysiology/Donor Blood Multip Female/HLA2
Pathophysiology/Activated complement cascade/effect
Pathophysiology/Alveolar leukocyte invasion/kinin release
Pathophysiology/Alveolar macrophage malfunction
Pathophysiology/Alveolar wall destruction
Pathophysiology/Anti-Recipient Neutrophile Antibodies
Process
PROCESS/Allergy/collagen/autoimmune (category)
PROCESS/Complicating disorder (ex)
PROCESS/Iatrogenic (category)
PROCESS/INCIDENCE/Rare disease (ex)
PROCESS/Inflammatory/Allergy/immune (ex)
PROCESS/Transfusion reaction (ex)
PROCESS/Immune system disorder (ex)
PROCESS/Immune/antibody-antigen system dis. (ex)
Synonyms
Synonym
TRALI, Transfusion related acute lung injury, Transfusion related acute lung injury (disorder), Synonym/Allergic pulmonary edema/TRALI synd, Synonym/Leukoagglutinin pulmonary reaction, Synonym/Pulmonary hypersensitivity reaction/TRALI synd, Synonym/TRALI syndrome, Synonym/Transfusion hypersensitivity lung syndrome
Treatment
Drug Therapy - Contraindication
RX/Blood transfusion/packed cells
RX/Diuretic
Drug Therapy - Indication
RX/Oxygen
Surgical Procedures or Treatments
TX/Rest-Time off
Other Treatments
TX/Expectant/supportive treatment.
TX/Intensive care management
TX/Intubation/ventilation assist.
TX/Ventilation Assist IPPB
Definition

Immune reaction usually to transfusion of allogenic leukocyte antibodies in plasma from donor often with fresh frozen plasma; reaction is at alveolocapillary level; this causes acute hypoxia and often goes on to ARD; donor should be excluded in future; occurs 1 to 2 hours after transfusion; with no hemolysis; anti-hla or granulocyte antibodies in donor 87% of time; restrict donor support patient; question steroid treatment, never diuretics

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External Links Related to Transfusion Related Acute Lung Injury/TRALI syndrome
Google
Wikipedia
Merck
Images
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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